Gastric and biliary excretion of meperidine in man

The role and importance of enterogastric secretion in the disposition and elimination of the weak base, meperidine (pKa 8.63), was studied after intravenous administration (50 mg) of the drug to 6 normal volunteers. Continuous collection of the gastric fluid over a 4-hr period demonstrated the establishment of high gastric fluid/plasma concentration ratios for meperidine (mean about 50, range, 10 to 200). However, the total amount of drug recovered, even after correction for incomplete collection, was only a small percentage of the administered dose. Under basal conditions a mean +/- SE of 1.9 +/- 0.3 mg, equivalent to 3.7% of the administered dose, was found in the total gastric aspirate. Stimulation of gastric secretion by subcutaneous injection of betazole (1.5 mg/kg) increased this recovery to 3.6 +/- 0.3 mg (7.2%) primarily due to the increase in gastric volumen output. Aspiration of the gastric fluid in either the basal or stimulated situation had no observable effect upon the plasma concentration/time profile of meperidine whether assessed by the terminal half-life, t 1/2 beta, or the plasma clearance; control values were 3.8 +/- hr and 1,190 +/- 130 ml/min, respectively. In 2 subjects "bile fluid" was also collected for 2.5 hr and found to contain less than 0.2% of the administered dose. Enterosystemic recycling is therefore of minor importance in the disposition and elimination of meperidine in man.     

The heroin epidemic in San Francisco: estimates of incidence and prevalence

Much attention has recently been focused on the question of the extent of heroin use in America. In a worthwhile effort to call public attention to the problem, many estimates of its size have evidenced a tendency toward exaggeration and aggrandizement. This paper presents methods of estimation of the extent of heroin addiction which, when carefully employed, should effectively correct such distorted estimates. Two general types of estimation are employed, incidence and prevalence. Incidence estimates are concerned with new cases of heroin addiction that occur in a specific population within a given amount of time. These estimates are based upon self-report data from addicts regarding date of first addiction. When corrected for the "lag phase" (that period of time between onset of first addiction and eventual visit to a treatment program), these data permit accurate retrospective charting of incidence trends. Prevalence estimates focus on all known cases of heroin addiction in a specific population within a given amount of time. Three separate types of prevalence estimates from three separate sources are outlined in this article: estimates based on overdose death data, estimates based on crime statistics, and estimates of "unknown" addicts. In outlining these methods, this article describes the fluctuations in heroin addiction in one major American city, San Francisco, California. After analyzing data gathered from a sample of 2,367 addicts contacted over a 3-year period, this study suggests that the incidence of heroin addiction seems to have declined after 1970. Possible factors underlying this apparent decline in heroin addiction are then discussed, including the post-1970 maturation of the "population at risk," the effectiveness of antidrug media messages, the changing drug fashions in the heroin subculture, and the gradual deterioration of the quality and potency of street heroin.     

Percutaneous radiologic drainage of pancreatic abscesses

OBJECTIVE: The purpose of our study was to review and report the patient selection, techniques, and results of percutaneous drainage of pancreatic abscesses by retrospective review. MATERIALS AND METHODS: Fifty-nine patients (46 men and 13 women) with a mean age of 44 years old had 80 pancreatic abscesses that were drained percutaneously under radiologic guidance (CT, n = 77; sonography, n = 2; and fluoroscopy, n = 1). Abscesses had a wide spectrum of causes, with alcoholic pancreatitis being most common, trauma second most common, and gallstones third. Ten patients had undergone surgery for pancreatic necrosis or abscess. Patients with pancreatic pseudocysts, necrosis, or acute fluid collections were excluded from this study. RESULTS: Of the 59 patients, 51 (86%) were cured with percutaneous drainage and antibiotic therapy. Of the patients who were not cured with percutaneous drainage, seven required surgery and one underwent repeat percutaneous drainage. In the 59 patients, complications included non-life-threatening bleeding in three patients. Ten of 59 patients (17%) had fistulas that spontaneously formed into the gastrointestinal tract. The duration of catheterization ranged from 4 to 119 days, with a mean duration of 33 days. The rate of mortality at 30 days after completion of percutaneous drainage was 8% (5 of 59). CONCLUSION: Percutaneous drainage was an effective therapy for this defined group of patients with pancreatic abscesses. Factors leading to the relatively high success rate described in this study likely included selection of patients; catheters of adequate size, number, and location; careful follow-up with appropriate catheter manipulations; and an integrated, cooperative approach whereby surgeons were willing to permit drainage to effect its benefits, rather than operating prematurely.     

PRACTICAL INCONSISTENCY MANAGEMENT FOR CRITICAL-TASKS DECISION-SUPPORT SYSTEMS

Abstract

In this paper, the problem of logical consistency in critical-tasks decision systems is addressed. It is shown how local search techniques can be used to check the (in)consistency of very large propositional knowledge bases (KBs). Using new heuristic findings. we can now implement efficient forms of diagnostic reasoning in the context of very large ICBs modeling deep models of complex devices and including patterns of default reasoning.     

Eliminating surface defects in rolled sheet due to vibration of the working cells

Surface defects of cold-rolled sheet in the form of transverse ribbing and cold-hardening bands are due to vibration in the working cells of the continuous rolling mill. The vibration is excited by impact of the working-roller supports on the frame’s supporting plane during reverse motion within the available gap. Means of eliminating these defects are developed on the basis of new approaches to cold-rolling theory.     

The in vitro and in vivo investigation of inhaled migraine therapies using a novel aerosol delivery system consisting of an air pressurized capsule device (APCD) in combination with a pMDI spacer for endotracheal dosing into beagle dogs

Abstract

Context: Aerosol delivery to animals in preclinical settings has historically been very challenging, requiring the use of techniques, such as intratracheal instillation and dry powder insufflation, that are somewhat invasive, inefficient and not representative of clinical inhalation.

Objective: The objective of this work is to develop a system to deliver dry powder to dogs in an efficient and effective manner for the study of new anti-migraine compounds in development.

Materials and methods: The new device uses a metered aliquot of a dry gas to force dry powder drug from a pre-filled HPMC capsule into an AeroChamber® spacer for subsequent inhalation by the animal.

Results: The delivery of two invesigational migraine drugs via the new device was assessed in vitro using abbreviated Andersen cascade impaction and showed the device is capable of generating a reproducible delivered dose of up to ～68% with more than 50% of the dose in the respirable range. In vivo studies have also been performed showing that this device effectively delivered the migraine drugs to spontaneously breathing dogs using a proprietary validated dog inhalation model.

Discussion: Results confirmed that the air pressurized capsule device (APCD) was effective in delivering the APIs to lungs of the animals. The in vivo data verified the advantages of inhaled delivery over oral delivery for this class of drugs and were used to establish the cardiopulmonary and respiratory side effect liability profile for these compounds.

Conclusions: This work has demonstrated the utility of this device for quick and accurate screening of prospective drug candidates, representing a significant improvement in ease of use and reprodicibility over current delivery methods.     

Prevalence of failure of passive transfer of immunity in newborn heifer calves and associated management practices on US dairy operations

Failure of passive transfer of immunity (FPT) in dairy replacement calves has been linked to increased neonatal morbidity and mortality and long-term decreases in productivity. The purpose of this study was to estimate the prevalence of FPT in US dairy heifer calves in 2007 and to use nationally representative data to investigate associations of FPT with colostrum and calf management practices. A cross-sectional study was conducted by the USDA's National Animal Health Monitoring System between January and August 2007. Producers from 394 operations in 17 states completed survey questions about colostrum and calf management practices, and serum samples were collected from 1,816 healthy heifer calves on those operations. Serum immunoglobulin G (IgG) levels were determined by radial immunodiffusion, and calves were classified as having FPT if the IgG concentration was less than 10 mg/mL. To investigate associations between FPT and management practices, a multivariable analysis was completed using a weighted logistic regression model. The estimated prevalence of FPT in US dairy heifer calves was 19.2%. The odds of FPT were higher for calves on operations that pooled colostrum [odds ratio (OR = 2.2)], allowed nursing (OR = 2.4), or hand fed colostrum more than 4 h after birth (OR = 2.7). The odds of FPT were also higher for calves on operations that did not provide a source of heat during cold weather for calves experiencing a dystocia (OR = 1.6), would not seek veterinary assistance when unable to correctly position a calf for delivery (OR = 2.6), or did not routinely monitor serum proteins in calves as a measure of passive transfer (OR = 13.8). The prevalence of FPT in dairy heifer calves has decreased in the last 15 yr, so progress has been made in this important area of calf management. This study identified several management practices associated with FPT that could be targeted for educational campaigns or further research.